Kocián J, Brunová J
Vnitr Lek. 1989 Jun;35(6):582-6.
The causes of impaired calcium, phosphorus and vitamin D metabolism in diabetic patients which in the long run lead to demineralization of bone can be summarized into several main groups. Above all disorders of calcium absorption from the small intestine are involved, associated with impaired absorption of vitamin D and its reduced conversion into active metabolites in the liver and kidneys. An increased elimination of calcium from the organism may also play a part (hypercalciuria, excretion in the faeces and sweat), hormonal changes (secondary hyperparathyroidism) and finally changes in the metabolism of the organic bone constituent--osteoid. Subsequent work will deal with the prevalence of osseous changes in diabetics, early diagnosis and rational treatment and possible prevention of these changes.
糖尿病患者钙、磷及维生素D代谢受损，最终导致骨质脱矿的原因可归纳为几个主要方面。首先是小肠对钙的吸收障碍，这与维生素D吸收受损以及其在肝脏和肾脏中转化为活性代谢产物减少有关。机体钙排泄增加（高钙尿症、经粪便和汗液排泄）、激素变化（继发性甲状旁腺功能亢进）以及最后骨有机成分——类骨质代谢的改变也可能起作用。后续工作将涉及糖尿病患者骨质改变的发生率、早期诊断、合理治疗以及这些改变的可能预防。
